Low priority prescribing survey analysis December 2016 Introduction The CCGs are making some changes in relation to an area called ‘low priority prescribing’ in line with many other NHS organisations in Lancashire and nationally. The CCGs are proposing to stop the funding of certain types of medicines or treatments that are readily available ‘over the counter’ in pharmacies or on the shelves in shops and supermarkets. The types of medicines and treatments that fall into this category include: • Treatments for minor ailments, including medicines like paracetamol, ibuprofen, head lice lotion and indigestion tablets. • Treatments where there is little evidence that they have a real clinical benefit, including cough syrups, nasal congestion sprays, sore throat products and vitamin supplements. Gluten free bread and flour. In some cases there will still be exceptions to this, such as the prescribing of some of these treatments for people with long term conditions, for babies and children, for breastfeeding mothers or when caring for people at the end of their life. In order to ensure that the proposals are sound, and the new prescribing policies are appropriate, a survey has been undertaken to capture the views of the local population. The survey A total number of 1,400 people completed the online survey (Appendix 1). Hard copies of the survey were provided to participants on request. Not every respondent completed each question. The number of responses received is illustrated next to each question. Where do respondents live? Of the 1,400 people completing the survey, a total number of 1,176 people reported where they lived. A breakdown of this is illustrated within Table 1. People from across Preston, Chorley and South Ribble completed the survey, with the majority of the responders stating that they lived in the Chorley (PR7 and PR 6 localities). A number of responders (224 people) skipped this question. This may be that they were out of area, or didn’t want to divulge this information. Table 1: Reported locality of responders Postcode and locality Number of responses PR1 Central Preston and Penwortham 5.3% (63) PR2 North Preston including Lea, Ashton, Fulwood and Grimsargh 4.51% (53) PR3 North Lancs including Great Eccleston, Pilling, Broughton, Goosnargh and Longridge 1.79% (21) PR4 West Preston including Wesham, Kirkham, Warton, Hesketh Bank, Much Hoole, Tarleton 3.06% (36) PR5 East Preston including Samlesbury, Walton-le-Dale, Bamber Bridge, Lostock Hall, Higher Walton 4.68% (55) PR6 East Chorley area including Brindle, Abbey Village, Brinscall, White Coppice, Heath Charnock 18.79% (221) PR7 West Chorley area including Buckshaw Village, Euxton, Eccleston, Heskin, Charnock Richard, Coppull, Adlington 42.77% (503) PR25 Central Leyland, Farrington, Clayton-le-Woods 10.63% (125) PR26 West Leyland including Croston, Bretherton, Farington Moss, Midge Hall and Moss Side 2.64% (31) How old are survey responders? The age of participants varied from under 18 years to 93 years and is categorised in Table 2. Out of the 1,400 people completing the survey, a total of 1,178 people stated their age. Most of the people responding to the survey were aged over 26 years, with the highest response rates from people aged over 61 years Table 2: Age of responders Age of 18 years and below 19-25 years 26-45 years 46-60 years 61+ years responders Number of 41 34 235 373 493 responses A total number of 1,188 responders stated their gender as illustrated in table 3. Most of the responders stated that they were female. Table 3: Gender of responders Male Female 421 767 Survey Responses A summary of the responses to each of the questions is detailed below. Question 1 - do you currently pay for prescriptions? A total of 1,394 people answered this question. Almost 60% of respondents (806 people) stated that they did not pay for their prescriptions compared to 41% (573 people) that said they do pay. Answered: 1,394 Skipped: 6 Yes No Don’t know 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 41.10% 573 No 57.82% 806 Don't know 1.08% 15 Total 1,394 Question 2 - Do you consider yourself to have a disability or long term condition? A total number of 1,391 people answered this question. Over 50% of responders (808 people) stated that they had a disability or long term condition, compared to 539 who stated that they don’t. Only nine people skipped this question. Answered: 1,391 Skipped: 9 Yes No Prefer not to say 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 58.09% 808 No 38.75% 539 Prefer not to say 3.16% 44 Total 1,391 Question 3 - Are you a carer or someone who has a carer? A high proportion of people (1,384) completing the survey answered this question. Most responders stated that they were not a carer or someone with a carer (81%). Only 16% of responders stated they were either carers or cared for. Answered: 1,384 Skipped: 16 Yes No Prefer not to say 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 16.18% 224 No 81.29% 1,125 Prefer not to say 2.53% 35 Total 1,384 Question 4 - Are you a parent? Out of the 1,385 people that responded to this question, almost 70% (966 people) stated that they were a parent. Answered: 1,385 Skipped: 15 Yes No Prefer not to say 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 69.75% 966 No 28.59% 396 Prefer not to say 1.66% 23 Total 1,385 Question 5 - Would you consider yourself to be in the category of either 'maternity', 'pregnancy' or 'breastfeeding mother'? Almost all responders (96%) stated that they were not in the 'maternity', 'pregnancy' or 'breastfeeding category. Answered: 1,388 Skipped: 12 Yes No Prefer not to say 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 1.44% 20 No 96.18% 1,335 Prefer not to say 2.38% 33 Total 1,388 Question 6 - Do you have coeliac disease? Under 10% of people responding to the survey stated that they had coeliac disease. Answered: 1,381 Skipped: 19 Yes No Prefer not to say 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Answer Choices Responses Yes 8.18% 113 No 89.21% 1,232 Prefer not to say 2.61% 36 Total 1,381 Question 7 - Please state if you think we should stop prescribing the medicines and treatments in the list below. Of the 1,334 responses received, most people stated that the prescribing of the medicines and simple treatments listed below should be stopped. Answered: 1,334 Skipped: 66 Simple pain killers Pain relief gels, creams and sprays Antihistamine tablets, capsules and liquids Nasal sprays for allergies Vitamins, minerals and health supplements Toothpastes, mouthwashes and mouth gels Sore throat and mouth ulcer products Nasal decongestant sprays, tablets and capsules Sun protection creams, lotions and sprays Warts and verruca treatments Antiperspirants Cosmetic moisturisers Cough syrups, linctus and mixtures Ear wax removers 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Yes No Don't know Yes No Don't know Total 79.79% 17.36% 2.85% Simple pain killers 1,062 231 38 1,331 65.63% 28.16% 6.21% Pain relief gels, creams and sprays 867 372 82 1,321 59.61% 33.56% 6.83% Antihistamine tables, capsules and liquids 785 442 90 1,317 55.48% 35.63% 8.89% Nasal sprays for allergies 724 465 116 1,305 82.31% 14.29% 3.40% Vitamins, minerals and health supplements 1,089 189 45 1,323 86.97% 9.64% 3.39% Toothpastes, mouthwashes and mouth gels 1,155 128 45 1,328 77.81% 18.47% 3.72% Sore throat and mouth ulcer products 1,024 243 49 1,316 71.03% 23.42% 5.55% Nasal decongestant sprays, tablets and capsules 934 308 73 1,315 89.20% 8.08% 2.72% Sun protection creams, lotions and sprays 1,181 107 36 1,324 67.33% 27.43% 5.24% Warts and verruca treatments 886 361 69 1,316 Antiperspirants 88.59% 7.79% 3.63% 1,172 103 48 1,323 85.90% 9.70% 4.40% Cosmetic moisturisers 1,133 128 58 1,319 81.69% 14.90% 3.40% Cough syrups, linctus and mixtures 1,080 197 45 1,322 Ear wax removers 72.78% 21.23% 5.99% 960 280 79 1,319 Question 8 Do you have any comments about this proposal? (medicines and treatments) A total of 681 comments have been received. Common themes in favour of stopping the prescribing of these medications and treatments include: These are available on the NHS These are cheaper to buy over the counter It will save the NHS a lot of money that can be used on other treatments Anything available over the counter that is cheaper than a prescription should be stopped Will save GP time (appointments) Patients told us: “A great idea” and “the sooner the better” “A sensible idea” “Will help reduce cost to the NHS” “Gob-smacked - I didn’t realise that you (NHS) prescribed all these” “Won’t need a GP appointment” There was, however, some concern about stopping the prescribing of these products. Common themes include: Some people on lower incomes may not be able to afford to buy these over the counter Elderly people may not be able to afford to pay for these People with long term conditions or serious allergies should have them on prescription Comments made by members of the public included: “Protection must be in place for people on low incomes” “The end of this will affect the most vulnerable” “These should be prescribed for the elderly” Question 9 - It would help us to understand why you are providing your feedback on this area - which of the below best describes you? (Tick all that apply.) Most people who responded to the survey described themselves as local residents.